Capitalist Corner

October 30, 2007

My Commenters Is Smarter Than I:"Giuliani vs. The Facts" Edition

Earlier today, I noted that Giuliani received his care for prostate cancer while still mayor of New York, which meant he was probably receiving insurance through the state of New York, utilizing one of those government-regulated purchasing pools he terms "socialism." Commenter anonymiss does me one better:

[T]he technique used on Giuliani, prostate brachytherapy--using radioactive seeds--was pioneered in the modern era by a physician in Denmark, and brought to the US by one of his students.

You'd think a guy whose life was saved by bradytherapy would admit, however grudgingly, that European socialized medicine ain't all bad.

And Tyro chimes in:

Given that the average age of patients diagnosed with prostate cancer is 70 (src), clearly a large number of patients are being treated by Medicare, America's very own form of socialized medicine.

So Giuliani's case for the superiority of our "free market" health care system goes something like this: While on health insurance provided by New York state, he was treated, using a surgery developed by Europeans, for prostate cancer, a disease that most commonly afflicts those covered by the federal government's single-payer health care system. Take that, Europe/national health insurance.

Comments

Take that, Europe/national health insurance.

Not that any of the horse-race tipsters give a shit. Let's be honest about this: Giuliani's healthcare policy is an 'eew' face when talking about foreigners, just as his foreign policy is an 'eew' face when talking about foreigners. He has no substance.

Seriously, though, I want you to memorize that last graf (ideally, in a tighter form) for future use on Hardball: 'he was covered by New York state, for a surgery developed by Europeans. for a disease that mostly affects people covered by single-payer healthcare-- that is Medicare.'

Posted by: pseudonymous in nc | Oct 29, 2007 11:53:14 PM

Is anyone else uncomfortable bringing Giuliani's health history into this? Universal care is either a good idea or it isn't, regardless of whether he's a hypocrite.

While Holm initially developed the technique in Denmark, the reason why the procedure gained acceptance was the work of Ragde in Seattle. In fact, the procedure was abandoned by the original group in Denmark for many years.

From Holm's own article, "The History of Interstitial Brachytherapy of Prostatic Cancer." Seminars in Surgical Oncology, vol 13, no 6, 1997.
"The number and severity of complications was quite unacceptable. Consequently,we stopped the treatment in 1987...Shortly after the development of this improved technique, however, we stopped our work with seed implantation. Before we did so, Dr. Ragde from Seattle visited the department in 1984 and 1986, studied the new seed implantation technique, and transferred it to the U.S. where it now seems to be gaining increasing acceptance. The reason for this success is first and foremost due to the efforts of Dr. Ragde and Dr. Blasko who have headed an extensive prostate implant program at the Northwest Hospital in Seattle since the late 1980s. They have taught numerous courses (ongoing), refined the technique—e.g., introduced the use of Pd-103, improved treatment planning and patient selection—and published extensively. Inspired by their very promising PSA results which compare favorably with radical prostatectomy and external beam radiation, we have decided to “close the ring” and restart ultrasound-guided transperineal seed implantation in the institution where it was developed almost 15 years ago."

Sorry, guys. A European may have come up with the idea, but it was Americans who took the idea, refined it, advocated for it, and turned it into the treatment that Giuliani got. Despite our system's faults, the profit motive and lack of central planning does make for an environment more conducive to innovation.

Posted by: umbrelladoc | Oct 30, 2007 1:25:23 AM

Hmm, Giuliani, ain't that the same guy who bloated about a misleading interpretation of statistic, allegedly showing that the chance to survive prostrate cancer is so much higher in the US when it really is on about the same level as in good ole Yurp? Didn't you run a story about this, Ezra?
:-)

"Sorry, guys. A European may have come up with the idea, but it was Americans who took the idea, refined it, advocated for it, and turned it into the treatment that Giuliani got. Despite our system's faults, the profit motive and lack of central planning does make for an environment more conducive to innovation."

Nonsense. In Europe, clinics and doctors make profits, too. And there isn't any big advantage showing up for the US in statistics. They have 26 deaths by prostrate cancer per 100000, Germany and France have 28. The difference is to small to be of any significance. Japan has 8/100k! Now, that's something that should be investigated. Is it a genetical virtue (totally possible), or do they have a better approach for curing the patients?

Trevor: You bring up a good point -- but. Being a cancer survivor does not prohibit one from making critiques about the health care system. Indeed, if Rudy were to candidly draw on his experiences to make some points about flaws in our system, that's fine. But Rudy's arguments fail on the level of argument, as Ezra noted, and on the level of hypocrisy. If you are waging an all-out assault on "socialized medicine," as Rudy is, it's fair to ask, "Wait a minute, if that's true, why did you yourself use it?" and also, "If you yourself used it, did it have negative consequences on you?" Apparently it didn't; instead of being dead or lying in hospital bed, Rudy's currently the frontrunner for the Republican nomination.

If Rudy has withering arguments against "socialized health care," I suggest he provide them. Until then, all he has is bullshit stats and a history with government-run health care that nullifies his argument.

New York State does not provide socialized medicine to its employees. Employees pay for a private insurance plan as part of the compensation for their work.
The employee picks the plan type, the benefits and can opt out of the system in favor of something else of their choosing. The insurance companies and the doctors are all private businesses.
THAT IS NOT SOCIALIZED MEDICINE.

Posted by: Patton | Oct 30, 2007 5:33:46 AM

So because Rudy advocates a particualr form of medical care delivery his private life is subject to dissection.

But, the Frosts, who advocated a plan Ezra likes, their private life is off limits.

Posted by: Patton | Oct 30, 2007 5:40:22 AM

So how many people will the left condemn to death in their National Health System??:

NHS staff crisis lengthens wait for cancer treatment
Hospital shortages have led to delays that are making some patients INCURABLE, according to figures revealed to The Observer.

Jo Revill The Observer Sunday March 23 2003

At least 57,000 cancer patients every year have to wait more than two months for their treatment to begin because severe staff shortages and lack of essential equipment cripple hospitals' ability to deliver faster care.

Some patients are becoming incurable because of delays before they can receive radiotherapy or chemotherapy or undergo an operation. ""

I think by becoming incurable, they mean the NHS condemned them to death. But of course you can't sue once the government controls healthcare.

So how do you think Hillarycare will determine who gets treatment? How big a campaign contribution? How much money you can bundle and send through straw donors? Or the old fashioned way, a nice BJ for Bill will get you seen by a doctor.

Posted by: Patton | Oct 30, 2007 5:45:04 AM

That's an opprtunity to corrwct some prejudices here:
Germany does not provide socialized medicine to its citizen. They pay a legally regulated insurance company for a standardized plan, and the employer pays a share of it as compensation for their work.
The employee picks the insurers, may order additional benefits and can opt out of the system in favor of another regulated system where he has to advance money for treatments and medicine that will be reimburesed by aprivate insurance company (this may be cheaper for younger people, but comes with a disadvantage at old age). Private insurance companies, clinics and doctors are all private businesses, working for profits, the legally regulated companies are nonprofits that compete with each other.
THAT IS NOT SOCIALIZED MEDICINE.
:Patton

Of course with Socialized medicince, we will be helpless against the political preferred patients and latest fads.

In race to treat cancer, are men sidelined by the NHS?
Lyndsay Moss 01 Jan 2007

Cancer treatment in Scotland appears to favour women over men, who face longer waits and delays in treatment, a leading doctor has warned.

Figures on cancer waiting times show that 88.2 per cent of breast-cancer patients are starting treatment within the two-month target from urgent referral by their doctor. But waiting-time for targets in urological cancers, including prostate and testicular cancers, hit only 67.5 per cent.

Dr David Love, joint chairman of the British Medical Association's GPs committee, said men might be the unintended victims of high-profile campaigns which have lobbied successfully to improve breast-cancer care.

The gender "bias" is most marked in the Borders. Up to 100 per cent of breast-cancer patients start treatment within two months, but for urological cancers, achievement of the target falls to a low of 54.5 per cent."""

Nice to know everyone is treated equally in socialized medicine...
I can see the poliically correct list of the left now of who will get priority:

"So how do you think Hillarycare will determine who gets treatment?"
How do you think medicare determines who gets treatment? And Hillary, or anybody else, would be ill advised to take the el-cheapo british system as a role model. It's problems are very well known, almost the only advantage is that it's costs are very low. Not a chance in hell that this system would be put into effect in the US, so your whole posting is baseless, P. Try harder.

Giuliani as a candidate for president isn't on the same level as the Frosts, he is legally obliged to provide some informations, even personal ones. All health care issues of candidates have been subject to public scrutiny, and Bush and Kerry didn't hesitate to convince voters that they are healthy enough to do the job, by providing evidence. Comparing the Frosts with Giuliani is comapring apples with a rotten tomato.
:P

I read in the NYT that $2 trillion out of total $2.6 trillion American healthcare bill is already government-funded. In terms of "socialized" healthcare, we are already there.

Posted by: bob h | Oct 30, 2007 7:37:25 AM

"$2 trillion out of total $2.6 trillion American healthcare bill"

Trillion? This sounds much too high for me. Do some quick math, that would be about a cool miilion for every single citizen. Wasn't the health care bill for the average US citizen at about 8000 bucks per year just some years ago???

I know that genetics is a problematic topic, dangerously close to racism, but it seems there are some differences that should be noted. I mentioned this in a comment from 2006, when the prostrate cancer issue came up the same time:

"Via google, I've checked some german sources about the differences in prostate cancer incidences. It looks like the US uses a method called PSA-screening for diagnosing prostrate cancer. This has led to a huge boost in numbers of possible cancer cases. My guess is that this method produces some false positives, too. Also it has to be taken into account that the average age for patients diagnosed with this is 72 years here in Germany. This is only slightly below the average lifespan for males. The methods of treatment are very advanced in all western countries, resulting in a high chances of containg the tumor even in advanced cases. The chances for surving five years are at 74-80%.

Also it is a fact is that the risk for prostrate cancers depends on genetical, cultural and social factors. In Asia, men are less likely to get it, but the risk for Afro-americans is twice as high as that for caucasian white males. Studies hint that the risk for a male in one country may be seventy times that of the average man living in another part of the world. And scientist at the State University of New York even conclude that stress at the job, with the family or in the surrounding may boost the risk by several hundred percent!

So, this is a very complex issue. And there are huge differencies between different countries. Imho it's impossible to draw any conclusions from a simple graph like the one that cannon is relying on for his dishonest statement."

"I'm not the one who started my radio ad, "5 or 6 years ago, I was diagnosed with prostate cancer.""

And after all that vigorous finger wagging about the frosts too.

Just to bring the the scale of the chutzpah into starker relief here is ezra explaining the reason for his windy and ever so slightly deranged(not to mention 'unsettling'!)criticism of malkin:

"there's a procedure to reporting. You identify your question, you gather your facts, you check your sources, and then you offer the finished product. What you don't do is choose a target, then unleash an all-purpose call for supportive speculation"

But today:

"Wouldn't it be interesting to find out if the gold-standard care Giuliani got during his prostate cancer came while he was on government-provided health insurance? He was mayor at the time, suggesting his care was coming through the city, which would suggest it was through the state insurance pool, which works very much like FEHBP -- which is what the Democrats are proposing to expand to all Americans, and what Giuliani is calling deadly, socialized medicine."

heh.

Posted by: pimp hand strikes! | Oct 30, 2007 8:54:29 AM

So because Rudy advocates a particualr form of medical care delivery his private life is subject to dissection.

But, the Frosts, who advocated a plan Ezra likes, their private life is off limits.

We're not discussing Rudy's private life. We're discussing a fact he introduced into the public discussion on healthcare: he had prostate cancer, and was treated for it successfully. No one has undertaken to discover if he really had prostate cancer in the first place, or how he paid for it, or if he properly qualified for care however he got it. And that's the difference, which if you weren't just a pathetic troll, you'd understand.

As mightygodking notes, the right-wing tack would be to say 'wasn't it convenient that Rudy's diagnosis for prostate cancer came just in time to prevent him getting smacked every which way but Sunday in the NY Senate race?' then would entail Stalkin' Malkin lurking a) outside Giuliani's doctor's office; b) behind the shower curtain in his bathroom, to get a good view up his ass.

What you don't do is choose a target, then unleash an all-purpose call for supportive speculation"

Dear limp hand: it's now 'speculation' to ask whether the mayor of New York City, holder of a office created under the auspices of New York state, was covered by the New York state health plan?

I'm a Californian transplanted to DC, and surprisingly at peace with it. Or at least I was till it started getting colder. Job-wise, I'm the staff writer for The American Prospect. In the past, I've written for the Washington Monthly, the LA Weekly, The LA Times, The New Republic, Slate, The New York Sun, and the Gadflyer. I'm a damn good cook. No, really. Want to know more? E-mail, I'm friendly.